CMS is requesting that an information
collection request to support the development of federal payment
rates for the Basic Health Program (BHP) be processed under the
emergency clearance process associated with Paperwork Reduction Act
of 1995 (PRA), specifically 5 CFR 1320.13(a)(2)(i). In accordance
with Section 1331 of ACA, the BHP is federally funded by
determining the amount of payments that the federal government
would have made through premium tax credits (PTCs) and cost sharing
reductions (CSRs) for people enrolled in BHP had they instead been
enrolled in an Exchange. In order to calculate these amounts for
each state, CMS needs the reference premiums for the second lowest
cost silver plans (SLCSPs) in each geographic area in a state, as
SLCSPs are a basic unit in the calculation of PTCs and CSRs under
the Exchanges. Relatedly, the reference premiums for these SLCSPs
are critical components in the BHP payment methodology in order to
estimate what PTCs and CSRs would have been paid. Similarly, CMS
also needs to collect reference premiums for the lowest cost bronze
plans to appropriately account for CSR calculations for American
Indians and Alaskan Natives. CMS recently determined that it does
not have sufficient data from State Based Exchanges (SBEs) to
determine the reference premiums for their SLCSPs and lowest cost
bronze plans. Reference premiums are foundational inputs into the
BHP payment methodology.
PL: Pub.L. 111 - 148 1331 Name of Law:
Patient Protection and Affordable Care Act
PL: Pub.L. 111 - 152 1331 Name of Law: Health Care and Education
Reconciliation Act of 2010
In this 2023 iteration, we
propose changes that relate to updates to BHP proposed in
CMS-1784-P and includes a revision of prior State burden estimates
related to the State’s Blueprint submission at § 600.125.
Additionally, this request revises the operation of a BHP. We
propose at §600.145(a), a State must implement its BHP in
accordance with (1) the approved and full certified State BHP
Blueprint; or (2) the approved suspension application. We propose
at § 600.145(f)(2) the State operating a BHP must perform
eligibility and health services appeals as specified in § 600.335.
We propose at § 600.330(f), BHP eligibility notices must be written
in plain language. Finally, this creates a new information
collection request for suspension of a BHP. We propose at
§600.140(b) if a State decides to suspend its BHP or requests a
suspension extension, a State must submit to the Secretary a
suspension application or suspension extension application. The
State must submit the annual report required by §600.170(a)(2) and
annually remit to HHS any interest that has accrued on the balance
of the BHP trust fund during the suspension period. We propose that
the State must submit a transition plan to HHS that describes how
the State will reinstate its BHP or terminate the program. Overall,
the rule would add 604 hours.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Form CMS-10510 Basic Health Program Supporting Regulations
CMS-10510 - Supporting Statement A (CMS-1784-P version 9).docx
Basic Health Program Supporting Regulations